This invention relates generally to surgical devices and more particularly to a surgical device for back operations.
Lower back surgery where a ruptured disk is involved has historically been a debilitating operation to a patient because the patient's back had to be opened up and the back muscles had to be cut so that the surgeon could see what he was doing. Accordingly, the consequence of such an operation was that a patient had to stay in a hospital for typically ten days even where the operation was successful in removing the ruptured portion of a disk.
Recent innovations in arthroscopic surgery have led to the use of tube techniques in back operations.
Where surgery is used for the removal and repair of tissue near the lower back, the only access to the area requiring removal that is available for the surgeon is the path used for the cutting instrument itself which is inserted into the back. That is, the opening must be small to avoid having to cut muscles in order to cut away the ruptured disk from the vertabrae.
In order for a surgeon to remove a ruptured portion of a disk the patient must be rested on his stomach, held in a stationary position, and only a local anesthetic used. See, for example, my U.S. Pat. No. 4,573,448 issued on Mar. 4, 1986. The patient is kept awake in order to prevent inadvertent injury to nerves. The surgeon counts the vertebrae to determine the exact position of the area in which the ruptured disk is located, and then a needle is inserted in order to find the ruptured disk.
After the needle is inserted, the C-arm of an X-ray unit is positioned in two different positions for taking X-rays of the location of the needle with respect to the vertabrae. When it is determined from the X-ray images that the needle is in the correct position with respect to the vertebrae, the stylet of the needle is replaced by a wire, the surgeon slides a probe over the wire, and inserts it into the same position at which the needle was located. By sequentially inserting a larger tube which is approximately five millimeters in diameter, the probe is then removed and there is then an orifice that is achieved which goes directly to the vertabrae at the location where the ruptured disk is attached, which orifice is approximately five millimeters in diameter.
A long narrow scissor device can then be placed through the narrow orifice to cut away from the vertebrae the ruptured portion of the disk. When the ruptured portion of the disk is cut away from the vertebrae, the loose portions of the disk can then be cut away from the disk. A problem that remains with this arthroscopic-like surgery is the need for accurate and efficient removal of the portion of the disk which has been ruptured and which has been cut away from the vertebrae and other loose tissue in the area, which problem is created by the fact that the surgeon cannot see the tissue being removed.
X-ray photographs must continually be taken during the surgery in order to determine the location of the cutting tool with respect to the vertebrae. The condition of the patient must also be monitored to determine that the cutting tools used to cut away and remove the ruptured disk are not impinging on any nerves of the patient.
Accordingly, a quick-acting tool has been required by surgeons which will not create a dangerous situation for the patient and cut away a nerve and also which will effectively and efficiently and accurately remove the ruptured portion of the disk and loose tissue in the area.
Thus, the need exists for a surgical instrument which facilitates insertion into the patient's back through an extremely small opening of the magnitude of approximately five millimeters which facilitates cutting away and removing all loose materials in the area where the ruptured disk has been cut away from the vertebrae.